DBS

Discussion in 'Neurology' started by BRAINTRAIN, 01.14.14.

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  1. BRAINTRAIN

    BRAINTRAIN

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    Hi, I wanted to know who exactly performs DBS? The neurosurgeon or the movement disorder trained neurologist?

    I know the neurologist decides the candidates for the procedure but who exactly performs the procedure?
     
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  3. NRC Advisors Program

    NRC Advisors Program

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    The neurosurgeon performs the implantation.
     
  4. Thama

    Thama 7+ Year Member

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    It is institution dependent. In some the neurologist refers and then gets the patient back for followup post procedure. In others, often the better and larger DBS centers, the neurosurgeon only performs the craniotomy and the neurologist does the targeting, intraop physiology and testing in the OR, as well as all the programming.
     
  5. NRC Advisors Program

    NRC Advisors Program

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    That is true, but if the question is who actually opens the skull and places the device, it is the neurosurgeon. The neurologist often assists with intra-op neurophysiology to aid with targeting, but he/she is not the one to actually perform surgery.
     
  6. BRAINTRAIN

    BRAINTRAIN

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    Got it! Thanks....
     
  7. modisrules

    modisrules 10+ Year Member

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    I have done lots of research in DBS and witnessed and/or assisted with approximately 100 procedures. The headframe application, initial targeting based upon imaging, scalp incision, burrhole drilling and dura incision is done by a neurosurgeon, who is fellowship-trained in stereotactic and functional neurosurgery. The neurophysiologic mapping with microelectrode recording is done either by a one or more of a neurophysiologist, neurologist, and the neurosurgeon. The management of the DBS post-surgery is usually done by the neurology team (specialized in movement disorders), though the neurophysiologist was involved in some programming and troubleshooting. Sometimes the neurologist and neurophysiologist are the same person. It is very much a team approach, but yes, the neurosurgeon is the only one doing the incisions, craniotomies, and physical device implantation.
     

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